Bone is a living tissue and, as such, requires all essential nutrients for growth and maintenance. A host of micronutrients are required to create and maintain the elaborate structure of bone mineral crystals deposited in connective tissue fibrils. Because bone turns over through continuous modeling and remodeling processes to shape bones during growth, to repair microarchitecture damage, and to respond to an ever-changing environment as we age, there are obligatory daily losses of bone constituents. As essential micronutrients, by definition, bone cannot be synthesized by the body (with the exception of vitamin D through Ultraviolet B exposure, they must be supplied through diet). Unfortunately, the Dietary Guidelines for Americans for several iterations have identified several of the most important nutrients to bone as shortfall nutrients, including calcium, vitamin D, and magnesium. Low intakes of calcium trigger the parathyroid hormone-vitamin D axis to increase calcium absorption at the gut and to decrease excretion at the kidney. Unfortunately, these processes are limited and
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